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AB0484 Lupus nehritis and pregnancy: maternal and fetal outcome
  1. PB Alba1,
  2. C Otaduy1,
  3. CA Gobbi1,
  4. A Alvarez2,
  5. A Albiero3,
  6. EH Albiero1,
  7. ML Propato2,
  8. MA Yorio1
  1. 1Rheumatology, Cόrdoba State University
  2. 2Rheumatology, Hospital Materno Neonatal
  3. 3Rheumatology, Hospital Cόrdoba, Cόrdoba, Argentina

Abstract

Background Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that primarily affects women during their reproductive years. The presence of Lupus nephritis (LN) may result in an increased risk of disease flare and adverse maternal and fetal outcomes, such as preeclampsia, fetal loss, and preterm delivery

Objectives The purpose of this work is to evaluate pregnancy outcome in SLE patients with previous diagnosis of LN.

Methods We retrospectively studied SLE patients according 1997 ACR criteria with previous diagnosis of LN by renal biopsy who attended to Materno Neonatal Hospital during the last 5 years. We evaluated demographic, clinical, laboratory and obstetric data. Renal biopsies were classified according ISN/RNP 2004. Lupus activity was evaluated by modified pregnancy SELENA SLEDAI score at the conception and during pregnancy. Maternal complications were evaluated: Preeclampsia, HELLP, Gestational Diabetes, Premature Rupture of the membranes, arterial and venous thrombosis, and others. Fetal outcome was evaluated as live birth, gestational age and weight at birth.

Results 44 pregnancies in 32 patients were included. Maternal mean age was 22,68 years old, mean duration SLE was 7.8 years and 22% had antiphospholipid syndrome (APS), 62.5% were from Cόrdoba city, 84.3% did not have health insurance, and they have mean previous pregnancies of 2 with 1 live birth. Maternal complications were: Pre eclampsia in 22.7% of patients, Preterm delivery in 20.45% of patients, Premature rupture of the membranes in 6.8%, Gestational Diabetes in 2.27% of patients. 14 patients had normal labour, 29 cesarean section and 1 abortion. 97% (n=42) of patiens have live birth with mean gestational age of 36 weeks with mean weight at birth of 2.399 g. and there was no maternal mortality.

Table 1.

Maternal Complications

Conclusions SLE patients with previous LN had a good maternal and fetal outcome in this study.

References

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  2. Lazzaroni MG, Dall'Ara F, Fredi M, Nalli C, Reggia R, Lojacono A, Ramazzotto F, Zatti S, Andreoli L, Tincani A. A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus. J Autoimmun. 2016 Nov;74:106–117. doi: 10.1016/j.jaut.2016.06.016. Epub 2016 Jul 2.

  3. Moroni G, Doria A, Giglio E, Imbasciati E, Tani C, Zen M, Strigini F, Zaina B, Tincani A, Gatto M, de Liso F, Grossi C, Meroni PL, Cabiddu G, Messa P, Ravani P, Mosca M. Maternal outcome in pregnant women with lupus nephritis. A prospective multicenter study. J Autoimmun. 2016 Nov;74:194–200. doi: 10.1016/j.jaut.2016.06.012. Epub 2016 Jun 30.

References

Acknowledgements We are grateful whit Secyt subsidy UNC.

Disclosure of Interest None declared

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